Does Urinary Incontinence and Mode of Delivery Affect Postpartum Depression? A Nationwide Population-Based Cohort Study in Korea

Abstract

We investigated the association between urinary incontinence and postpartum depression. Data were extracted from the Korean National Health Insurance Service-National Sample Cohort and included women who delivered between 2004 and 2013. Postpartum depression was determined using diagnostic codes during the six-month postpartum period. Urinary incontinence was identified as having a prescription of incontinence drugs or a diagnosis. Cox proportional hazard models were used to calculate adjusted hazard ratios. Of the 83,066 women, 5393 (6.49%) had urinary incontinence and 691 (0.83%) had postpartum depression. Postpartum depression was higher among women with urinary incontinence, aged 15–19 years, ≥40 years old, the lowest income level, and who underwent cesarean section delivery. In the combined analysis, women with urinary incontinence and cesarean section had an approximately three times higher risk of postpartum depression compared with those without urinary incontinence and with spontaneous delivery. Women without urinary incontinence and cesarean section, and those with urinary incontinence and spontaneous delivery were at higher risk of postpartum depression compared with the reference group. Urinary incontinence and cesarean section delivery were significantly associated with postpartum depression during the first six months after childbirth. Therefore, further research should be conducted to evaluate whether urinary incontinence contributes to postpartum depression.

Şanlıurfa’da Postpartum Üriner İnkontinans Prevalansı ve Etkileyen Faktörler

“…Üriner inkontinans, kişinin miktarı fark etmeksizin istemsiz olarak idrarını kaçırma durumudur ve dünya genelinde daha sıklıkla kadınlarda görülmektedir (15,18,19). Kadınların gebelik ve doğum sürecine maruz kalmaları Üİ'nin postpartum dönemde sık görülmesindeki en büyük etkenlerdir (5,10,13,17,20).…”

“…Dünyada postpartum Üİ prevalansı %6.49 ile %55.0 gibi geniş bir aralıkta değişkenlik göstermektedir (10,12,13,21). Ülkemizde ise postpartum Üİ prevalansı %13.5 ile %55 arasında değişmektedir (16,(22)(23)(24).…”

“…Tüm bunların yanısıra Üİ'ın, gebelik sırasında meydana gelebilecek nöromüsküler üretral sfinkter fonksiyonundaki değişikliklerden de kaynaklanabileceği ve bu durumun postpartum dönemde de devam edebileceği belirtilmektedir (8,9). Literatürde postpartum Üİ prevelansı %6.49 ile %55 arasında bildirilmektedir (10)(11)(12)(13). Şanlıurfa, Türkiye'de toplam doğurganlık hızının ve kaba doğum hızının en yüksek olduğu ildir (14).…”

Urinary incontinence in the postpartum 1‐year period: Its prevalence and effect on psychosocial status of women

“…Among the causes of the prevalence of urinary incontinence in the postpartum period are hormonal and urinary system changes occurring as a result of pregnancy and changes in the muscles and connective tissue occurring in the postpartum period. Mothers being older than 35 years, high body mass index (BMI), and high number of vaginal childbirths are accepted as risk factors for urinary incontinence 4,8,9 . Although most women experience urinary incontinence problems in the postpartum period, only 25% of these women seek professional help 5 …”

“…Mothers being older than 35 years, high body mass index (BMI), and high number of vaginal childbirths are accepted as risk factors for urinary incontinence. 4,8,9 Although most women experience urinary incontinence problems in the postpartum period, only 25% of these women seek professional help. 5 One of the biggest problems that negatively affect women's health-related quality of life in the postpartum period is UI.…”